MSF Letter to the Heads of the Trade Delegations of G4 Countries

Mr. Kamal Nath, Hon’ble Minister of Trade & Commerce, Government of India
Ms. Susan Schwab, United States Trade Representative
Mr. Peter Mandelson, European Union Trade Commissioner
Mr. Celso Amorim, Hon’ble Foreign Minister, Government of Brazil

New Delhi, April 10, 2007

Re: WTO trade talks in New Delhi, 11th & 12th of April

Dear Excellencies,

We are writing to you on behalf of Medecins Sans Frontieres (MSF) on the eve of the G4 trade talks in New Delhi.

We understand that this round of trade discussions will focus on agriculture and that the trade delegations from the United States of America, Brazil, the European Union and India are firmly committed to find solutions to reinvigorate the Doha Round.

We would like to draw your attention to another crucial aspect of the trade negotiations, notably the 2001 Doha Declaration’s commitment to public health, and urge you to sustain your support for the measures undertaken by the governments of India and Thailand to safeguard public health interests.

Public health interests in these countries have been threatened by the actions of Novartis, Abbott Laboratories and other actors.

The 2001 WTO Doha Declaration on TRIPS and Public Health was a vital step in increasing access to medicines. It provided unambiguous support to any government that needs to protect the health of their people and therefore use TRIPS flexibilities to overcome the barriers posed by patents.

The AIDS epidemic has most starkly highlighted the need to ensure that essential medicines are available at affordable prices. Today a majority of people in the developing world who receive antiretroviral drugs rely on generic production in India.

The fixed-dose drug combinations, produced in India, greatly simplify the administration of antiretroviral therapy and have been critical to scaling up HIV/AIDS treatment in resource-poor settings.

India in March 2005 introduced a product patent regime in full compliance with the TRIPS agreement. The impact of patent protection in India on HIV programmes is increasingly apparent now as large numbers of people living with HIV/AIDS on treatment in developing countries will need to switch to newer, second line medicines.

These newer drugs are at least 4-10 times as expensive as the existing treatments, as almost all are patented or are likely to be patented. This is notwithstanding the fact that countries like India, Brazil and Thailand have the capacity to produce generic version of these drugs.

MSF would like to express its concerns that the interpretation of TRIPS in keeping with the 2001 Doha Declaration’s commitment to public health concerns is now being unjustly challenged in India and Thailand as demonstrated by the actions of companies such as Novartis and Abbott Laboratories.

MSF feels that measures being undertaken by India and Thailand to implement TRIPS flexibilities to protect public health should receive crucial support from the G4 countries as a reaffirmation of their commitment to the Doha Declaration on TRIPS and Public Health.

Today MSF is treating 80,000 people living with HIV/AIDS in 30 different countries. Obviously, medical needs of MSF’s patients are only an indication of the problems governments throughout the developing world will face.

Without the implementation of public health safeguards agreed upon in the 2001 Doha Declaration, treatment costs may increase dramatically in the next few years as significant number of patients will require second-line medicines. It should also be noted that the impact of patents is not limited to antiretroviral drugs, but will increasingly be felt across all diseases with all medicines brought to market from now on.

In view of the above, we request the G4 countries to increase their efforts to support access to medicines and specifically request you to raise the public health concerns at the discussions in New Delhi and reaffirm your commitment to the 2001 Doha Declaration.

A statement on your behalf, that will support India and Thailand’s right to implement public health safeguards in TRIPS to address essential health needs by increasing access to affordable medicines, will be welcomed by millions of patients in the developing world.

We would be very happy to meet with you to discuss the issues mentioned above in more detail.

Sincerely yours,

Johannes van de Weerd
Head of Mission, Medecins Sans Frontieres Holland (in India)
C 106 Defence Colony
New Delhi 110 024, India
Tel: 91 11 24332419, 91 9810114884

Dr. Tido von Schoen-Angerer
Director, Campaign for Access to Essential Medicines
Médecins Sans Frontières
Rue Lausanne 78 CP 116 CH-1211
Geneva 21
Tel: +41 79 701 9989

Thailand issues compulsory licenses for essential drugs

In the case where governments are directly involved in providing treatment to their citizens, issuing a compulsory license for generic importation or local production is often the only solution to solve procurement problems and access drugs of public health importance at an affordable price. The Thai government was confronted with similar problems and had to make the decision on issuing compulsory licenses to solve the problem of accessing affordable drugs for the health schemes under which their citizens, including people living with HIV/AIDS access treatment. The licenses issued by the Thai government authorize the procurement of affordable generic drugs for government use overriding the patent rights of pharmaceutical companies. The use of compulsory licenses to improve access to essential medicines is consistent with the 2001 Doha Declaration. Notwithstanding Thailand’s legal rights, Abbott Laboratories the Chicago-based multinational pharmaceutical company has cited Thailand’s use of compulsory licenses as a reason for not marketing its new medicines in Thailand.

India includes public health safeguards in its patent law

Rules of the World Trade Organization’s Agreement on Trade-related Aspects of Intellectual Property Rights (TRIPS) obliged India to begin reviewing pharmaceutical patents in 2005. The TRIPS agreement, however, includes pro-public health safeguards that countries can implement, and India has included some of these in its patent law. India’s patent law restricts patenting of medicines to innovations only. A crucial part of the Indian law protects patients from the patenting of trivial improvements of known molecules. The Doha Declaration on TRIPS and Public Health, signed by governments in 2001, reinforced the right of countries like India to use such safeguards. Novartis, a Swiss pharmaceutical company has legally challenged the specific provision in India’s patent law that restricts patenting of medicines to innovations only. If these provisions were overturned, patents would be granted far more widely in India, heavily restricting the production of affordable medicines that has become crucial to the treatment of diseases across the developing world.

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